The purpose of the proposed research is to develop and evaluate the effectiveness and cost of a practice guideline for preventive diabetic foot care. A practice guideline for preventive diabetic food care will be developed using current research literature consensus of experts, and American Diabetes Association Standards. The effect of the preventive diabetic foot care guideline on patient outcomes will be evaluated using a two group, before-after experimental design. The cost of implementing the guideline as compared to usual clinic care will be determined.